"The Evil That Men Do Lives After Them; The Good is Oft Interred with their Bones" Dec 20, 2018 -
Mr. J. A. McNamara
Mark Anthony 40 AD
I was recently honoured to be invited to present Grand Rounds at Cork University Hospital on the occasion of the 40th anniversary of the opening of the hospital. I chose to present on the development of the hospital over that period and the likely future for it over the coming decade, in a metaphorical way through the words of Mark Anthony in his inspirational speech given at the funeral of Julius Caesar. In doing so I addressed a number of themes that can be viewed by clicking here.
I will return to the theme of legacy which I believe the title of this piece relates to, but in the first instance Mark Anthony references ambition when he says;
“The Noble Brutus Hath Told You That Caesar Was Ambitious; If It Were So It Was a Grievous Fault and Grievously Hath Caesar Answered it.”
The hospital has been very ambitious over the past twenty years and has seen significant consolidation and expansion of services while successfully competing with the private sector and in the process generating over €60m annually in private income to support service development.
I want to reference another theme in Mark Anthony’s speech on the issue of resourcing when he says:
“He Hath Brought Many Captives Home to Rome Whose Ransoms Did the General Coffers
In relation to the accretion of resources to the hospital in terms of capital and revenue funding (as a proxy for service development) the following facts are worth noting:
- The hospital has successfully secured capital investment, over two decades, of c. €500m which has enabled the physical enlargement of the campus and the provision of infrastructure which befits the excellent work that our staff do every day;
- The complexity of services provided by the hospital has expanded exponentially with the support of the National Care Programmes of the HSE and the Department of Health;
- Following the low point (post the Government moratorium) of 2011, the number of staff employed in all grades has risen by 750 people;
- In that period from 2012, the revenue budget for the hospital has increased by €70m to €370m;
- In 2017, the Government designated the hospital as one of only two Trauma Centres in Ireland, a designation which ensures continuous development of services related to trauma care for the next decade;
- At a time of enormous concern at the damage being done to the environment, Cork University Hospital remains the only hospital in the world to be awarded the Green Flag by the international Federation of Environmental Education following external assessment.
By any measure these summary achievements represent success and have enabled the hospital increase its complexity and therefore its capacity to meet the needs of the population we serve, while being sensitive to the values that we believe are important.
This sensitivity to the values that define the hospital is incredibly important because those values help shape its culture and define behaviours that are acceptable or not. In this regard, one of the key values that staff are expected to uphold is that of fairness in the pursuit of justice and truth and I hope that hospital leadership at all levels are guided by this laudable goal.
In my view it is critical for hospital leadership to maintain independence of thought, an ability to objectively evaluate situations in arriving at decisions, a capacity to practice fairness and adherence to values that reflect those of the hospital.
Personally, I have found, in almost three decades of being CEO of Cork University Hospital, that maintaining this degree of autonomy free, of the constraints that come with social fraternisation and familiarity, has been of particular importance as I seek to be objective and fair. The extent to which I have been both objective and fair is something that others will adjudge for themselves.
In his words during the course of his speech, Mark Anthony also makes the observation that
“Oh Judgement! Thou Art Fled to Brutish Beasts and Men Have Lost Their Reason”
I see this as an invitation to seek out the truth in everything that we say and do. This search for the truth requires consideration, thought and reflection, behaviours that are oftentimes lacking in a world driven by immediacy and the rush to judgement. One wishes (perhaps forlornly) that public discourse on so many aspects of our society, including our health system, was more informed than is typically the case in our modern world.
To return to Mark Anthony and his observations that “The Evil That Men Do” etc., he is probably correct that in the human condition regrettably reside those negative characteristics and qualities that sometimes disable us from acknowledging the good in each other and celebrating achievement. Instead how often do we display behaviours that are the product of jealously, of personal prejudice and of a myopic view of the world.
J. A. McNamara
Chief Executive Officer